HomeMy WebLinkAbout202 BradshawCITY OF
Sk_N'q FORD
PERMIT APPLICATION
BUILDING DIVISION
Application No:
\ ,Documented Construction Value: $ ��
Job Address: ��C�S Historic District: Yes ❑ No❑
Parcel ID:
Residential ❑ Commercial ❑
Type of Work: New K Addition ❑ Alterations❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: I�
�--
Plan Review Contact Person:
Phone: Fax: Email:
Property Owner Information
Name Phone:
Street: Resident of property?:
City, State Zip:
Contractor Information
Name - \&- Phone: Z167- 04tI " 415W
Street: \�zs Fax: M-tNi- 5133
City, State Zip: � �,� �L. 3z` to State License No.: C'FC. \L W 60q
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior
to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand
that a separate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners,
etc
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 6" Edition (2017) Florida Building Code
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public
records of this county, and there may be additional permits required from other governmental entities such as water management districts, state
agencies, or federal agencies.
r
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required in order to
calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal. The actual construction value
will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in accordance with local ordinance. Should calculated
charges figured off the executed contract exceed the actual construction value, credit will be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be
done in compliance with all applicable laws regulating construction and zoning..
Signature of Owner/Agent Date 4i,<1',,re of Con ,tor gent 11p,
Date
Print Owner/Agent's Name
Signature of Notary -State of Florida IDate
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Print Contractor/Agent's Name
Signature ofNota, - to ps lorida DEBBIE6t.f��t�l—_—}
P MY COM�9IS1,01 # FF 178H8
EXPIRES: Febru - ' 25, 2019
N �.:..... c:
of t�4� bonded Thru Notary Public L'ndenro'riter„ it
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID :V-L
ev,,, I(�_-c,iIp
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing ❑ Gas ❑ Roof ❑
Construction Type:
Occupancy, Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 8 - 13 -19
1 hereby name and appoint: 6 rec or V Ta V 10 f-
an agentof. PICA- S 'ct�e Plumbin , Inc.
(Name of Company)
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
The specific permit and ap lication for work located at:
o2 o c2 clsh a tv
(Street Address)
Expiration Date for This Limited Power of Attorney: t Z - 31- 2-01 S
License Holder Name: Orin G. Coo Pei
State License Number: C FC tL+Z_ (P (o 94
Signature of License Holder: co 1';_
STATE OF FLORIDA
COUNTY OF OrG2
The foregoing instrument was acknowledged before me this Q; "day of AuQus� ,
200 8 , by Orin G. Coo der who is )(person lly known
to me or ❑ who has produced as
identification and who did (did not) take an oath.
Signature
(Notary Seal)
=INtate of Florida
daro GG 170667022
(Rev. 08.12)
GAkMEN L 60/2J,C o
Print or type name
Notary Public -State of rj_ 0R1 L)A
Commission No. G& 170(o4,7
My Commission Expires: y-/$-Z0dA
L�'1I
PROPOSAL J CONTRACT
Habitat (Seminole)
Date: 7/20/2018
We propose to furnish material and labor for the electrical work at
job name: 202''W. Bradshaw & 131 W. 13th St (728 sq. ft.)
for the sum of $ 4,250.00
Which will be done per the;following schedule:
11 Lighting Outlets
0 Post Light Outlets
3 Paddle Fan Outlets
0 Paddle>Fan installation
13 S.P. Switch Outlets
2 3-Way Switch Outlets
0 4-Way Switch Outlets
'27 Duplex Receptacles.
2 Weatherproof Outlets
1 Washer Outlet
1 Dryer Outlet
1 Furnace Outlets ( 5 kw )
1 Air Conditioner Outlet ( 3 ton
1 Dishwasher Outlet
1 Disposal Outlet
4 Recess Lights
1
Push Button Outlet
1
Chime Outlets
3
T.V. Outlets
3
Telephone Outlets
3
Smoke Detectors
0
Floor Outlets
1
Range Outlets.
0
Overt Outlets
1
Water Heater Outlets
1
Bath. Fan Outlets
0
Bath Fan #
Kitchen Hood Outlet
0 Jacuzzi Outlet
1 Garage Door Outlet
0 Microwave Outlet
This Includes 150 Amp Maim Service.
This Includes NO Allowance For Fixtures. (Except As Noted)
This Includes Hanging Fixtures and Connecting Equipment.
TERMS AND CONDITIONS: SEE THE'REVERSE SIDE OF THIS PROPOSALICONTRACT FOR ADDITIONAL TERMS AND CONDITIONS,
ALL OF WHICH THE UNDERSIGNED SPECIFICALLY ACKNOWLEDGES AND AGREES TO ABIDE BY IF YOU WISH TO ACCEPT
THIS PROPOSAL AND WISH US TO PROCEED, KIND SIGN AND RETURN AN EXECUTED COPY TO STE ELECTRICAL SYSTEMS,
RETAINING THE ORIGINAL FOR YOUR RECORD THIN 30 DAYS.
Accepted By:
For S.T.E'
Date:.
Date:
Clarence Tibbs
Post Office Box 2011 • Apopka, Florida 32704-2011
11 39Ocoee Apopka Rd. Apopka, Florida 32703 • (407) 884-7383
EC0000582•ECO000900 EC1 3006500 - EC1 3006970